I occasionally have issues with my temper; this mostly manifests itself in the form of sweary ranting. I returned to work on Monday after a week off, following my last exciting night wherein there was a catastrophic breakdown of the the therapeutic relationship.
This led to an assault on my person, and some inconvenience to my life in general, and has not pre-disposed me to feel good about my fellow humans. Which is unfair. I had a disagreement with one individual, not everyone; but I have found myself more grumpy than usual.
While I feel happy that I have dealt with how I feel about last week's incident, it seems that my subconscious may disagree. I capped my day off by performing a substandard manipulation on a distal radius fracture, requiring me to ask for assistance from the Orthopods; I was then fortunate to meet possibly the rudest Orthopod I have ever come across.
Which is saying something.
I realise it's not fun for them to have to remanipulate a fracture I should have done better with, but surely everyone has an off day?
Or maybe, just maybe I'm being a bit over-sensitive and grumpy.
Showing posts with label Rude Surgeons. Show all posts
Showing posts with label Rude Surgeons. Show all posts
Wednesday, January 27, 2010
Saturday, January 02, 2010
What Would You Liike Me To Do?
An interesting shift; not as busy as I thought it might have been...
There is,as many of you will know, an ongoing struggle for us in the ED to convince our Specialist brethren that once in a while, we know what we're about.
I saw a young woman yesterday, with a long, complex history; the sort of history that makes life difficult for you - a mixture of physical and psychological, God-given and self afflicted. She has had many admits with belly-ache, and mostly managed with difficulty.
Yesterday she presented a week after taking a substantial overdose of tramadol, complaining of abdominal pain and an inability to open her bowels. So far, so constipation; except that her pan was uncontrollable (which may represent real pain, or simply a desire to obtain more morphine...) her pulse racing, and her lactate sky-high.
Her belly was tight, exquisitely tender, and I called for a surgical consult. The first surgeon I spoke to me told me he thought it all sounded "very soft". You can interpret that any ay you want, but I'm a stickler for tradition, and like my patients examined before their complaints are dismissed as "soft"
The next surgeon's input was limited to asking me what I was doing about the tachycardia?
Well, I've tried agressive fluids, enough morphine to kill a horse, and antibiotics in case she's perfed... I'm kind of stuck; so what I did was... call you.
There is,as many of you will know, an ongoing struggle for us in the ED to convince our Specialist brethren that once in a while, we know what we're about.
I saw a young woman yesterday, with a long, complex history; the sort of history that makes life difficult for you - a mixture of physical and psychological, God-given and self afflicted. She has had many admits with belly-ache, and mostly managed with difficulty.
Yesterday she presented a week after taking a substantial overdose of tramadol, complaining of abdominal pain and an inability to open her bowels. So far, so constipation; except that her pan was uncontrollable (which may represent real pain, or simply a desire to obtain more morphine...) her pulse racing, and her lactate sky-high.
Her belly was tight, exquisitely tender, and I called for a surgical consult. The first surgeon I spoke to me told me he thought it all sounded "very soft". You can interpret that any ay you want, but I'm a stickler for tradition, and like my patients examined before their complaints are dismissed as "soft"
The next surgeon's input was limited to asking me what I was doing about the tachycardia?
Well, I've tried agressive fluids, enough morphine to kill a horse, and antibiotics in case she's perfed... I'm kind of stuck; so what I did was... call you.
Thursday, July 17, 2008
If I Should Fall To Rise No More...
Another one of us runs aground; a fellow blogger, whose work I try to follow closely has been rumbled. It's always a risk, if one tries to keep this sort of thing secret. For those of us who blog about events that might have involved other people have to worry about libel, and, for the medical blogger, issues of confidentiality.
There have been a few relatively high profile cases, and I think it's why most, if not all of us write hypothetical, or composite cases. I occasionally mention real people, and talk about patients, but I remind you all once again that the details of the cases are representative only.
Except of course when I saw that Patricia Hewitt is a bitch. That's true.
Fact.
Anyway, I'm not sure what fate awaits our fellow blogger. People I work with know I blog, but have chosen not to take me to task over it; I'm fairly sure my writing is cast iron enough. I guess it's probably good advice not to describe colleagues in a derogatory way unless you don't care if they read it.
Which brings me nicely onto another rant about my surgical colleagues. I apologise for the overly whiny nature of my recent posts. But I need to vent. Colossus, God love him, had to endure my initial autologous autosplenectomy on my way out this eve. Now I choose to share it with y'all. I'm trying to vent enough that I won't chew La Belle Fille's ear off.
In defence of my colleagues, I'm sure they are all excellent surgeons; and, I have no doubt, that if you quizzed them about me, there would be plenty with which they could find fault. It is easy to paint a picture that seems to make your point of view the reasonable one. What follows is thus not an objective telling.
It's my blog, however.
Again, this morning, the facial surgeon was confronted with a patient with diabetes. The mere presence of this rare and exotic condition seems to have struck fear into their hearts, and they duly requested a medical review. When they were directed in the direction of the phone, and provided with the bleep number, the better to discuss the case themselves, it was decided that, perhaps, discussion with the duty magicians was not necessary, but would the nurses ask me to look over the results.
When I was a wee fungus, we always directed our questions up the chain before going sideways. I'm not sure when that stopped.
The patient managed to give their own insulin, as they do every day, without sustaining horrific mishap, and got to outpatients in one piece.
This afternoon, I spent a joyous time talking on the phone to several of my colleagues; my conundrum concerned a young woman, obviously shocked, with obviously intra-abdominal mischief. The cause was not immediate apparent, but we were leaning toward an abdominal aneurysm. The General Surgeon was sure it was an aneurysm, and wanted a scan. He was reluctant to see, or touch the patient. The Vascular Surgeon was equally sure it was not an aneurysm, and wanted a scan. He was equally reluctant to see, or touch the patient. I eventually managed to get them together, but this did nothing to disabuse me of the idea I have that we are increasingly substituting 'a scan' for examination of the patient.
Interestingly, despite all the assurances to the contrary I received from the Vascular boys that an aneurysm was not the problem, the scan suggested otherwise. I saw the vascular boys after the scan; no comment passed between us about how interesting the results of the scan were; I suppose they were rushing too quickly to theatre to talk.
Lastly, and what eventually kept me at work two hours after I should have left, I spent some considerable time with a young patient. They have a complex psychological disorder, which results in frequent visits to the ED. Much time has been devoted to the investigation of their symptoms, and they frequently take their own discharge. Tonight was no exception, but what nearly pushed me over the edge was when the patient was returned, against their will, by two well meaning non-clinical staff. Despite my best efforts, I surely felt that they considered me derelict in my duty, as our patient did not look well. The idea of capacity, and right to refuse treatment did not seem to compute. We eventually parted company, agreeing to differ, as my well meaning colleagues were not willing to wrestle to patient into the Department, not willing to section someone they know nothing about. Which is just as well, since merely behaving in a way you don't approve of is not grounds for declaring someone mentally incompetent.
I suspect I may hear more about this one.
I'll try to be less sanctimonious tomorrow; I'm sure it doesn't become me...
There have been a few relatively high profile cases, and I think it's why most, if not all of us write hypothetical, or composite cases. I occasionally mention real people, and talk about patients, but I remind you all once again that the details of the cases are representative only.
Except of course when I saw that Patricia Hewitt is a bitch. That's true.
Fact.
Anyway, I'm not sure what fate awaits our fellow blogger. People I work with know I blog, but have chosen not to take me to task over it; I'm fairly sure my writing is cast iron enough. I guess it's probably good advice not to describe colleagues in a derogatory way unless you don't care if they read it.
Which brings me nicely onto another rant about my surgical colleagues. I apologise for the overly whiny nature of my recent posts. But I need to vent. Colossus, God love him, had to endure my initial autologous autosplenectomy on my way out this eve. Now I choose to share it with y'all. I'm trying to vent enough that I won't chew La Belle Fille's ear off.
In defence of my colleagues, I'm sure they are all excellent surgeons; and, I have no doubt, that if you quizzed them about me, there would be plenty with which they could find fault. It is easy to paint a picture that seems to make your point of view the reasonable one. What follows is thus not an objective telling.
It's my blog, however.
Again, this morning, the facial surgeon was confronted with a patient with diabetes. The mere presence of this rare and exotic condition seems to have struck fear into their hearts, and they duly requested a medical review. When they were directed in the direction of the phone, and provided with the bleep number, the better to discuss the case themselves, it was decided that, perhaps, discussion with the duty magicians was not necessary, but would the nurses ask me to look over the results.
When I was a wee fungus, we always directed our questions up the chain before going sideways. I'm not sure when that stopped.
The patient managed to give their own insulin, as they do every day, without sustaining horrific mishap, and got to outpatients in one piece.
This afternoon, I spent a joyous time talking on the phone to several of my colleagues; my conundrum concerned a young woman, obviously shocked, with obviously intra-abdominal mischief. The cause was not immediate apparent, but we were leaning toward an abdominal aneurysm. The General Surgeon was sure it was an aneurysm, and wanted a scan. He was reluctant to see, or touch the patient. The Vascular Surgeon was equally sure it was not an aneurysm, and wanted a scan. He was equally reluctant to see, or touch the patient. I eventually managed to get them together, but this did nothing to disabuse me of the idea I have that we are increasingly substituting 'a scan' for examination of the patient.
Interestingly, despite all the assurances to the contrary I received from the Vascular boys that an aneurysm was not the problem, the scan suggested otherwise. I saw the vascular boys after the scan; no comment passed between us about how interesting the results of the scan were; I suppose they were rushing too quickly to theatre to talk.
Lastly, and what eventually kept me at work two hours after I should have left, I spent some considerable time with a young patient. They have a complex psychological disorder, which results in frequent visits to the ED. Much time has been devoted to the investigation of their symptoms, and they frequently take their own discharge. Tonight was no exception, but what nearly pushed me over the edge was when the patient was returned, against their will, by two well meaning non-clinical staff. Despite my best efforts, I surely felt that they considered me derelict in my duty, as our patient did not look well. The idea of capacity, and right to refuse treatment did not seem to compute. We eventually parted company, agreeing to differ, as my well meaning colleagues were not willing to wrestle to patient into the Department, not willing to section someone they know nothing about. Which is just as well, since merely behaving in a way you don't approve of is not grounds for declaring someone mentally incompetent.
I suspect I may hear more about this one.
I'll try to be less sanctimonious tomorrow; I'm sure it doesn't become me...
Wednesday, April 09, 2008
Skimming The Knee
We were talking yesterday about Doctors we knew with... interesting personalities. A surgeon I worked for cropped up. He was a brilliant man. A plastic surgeon, with an amazing eye for scars. His speciality was burns and reconstructive surgery. He could look at a scar and, in a flash, tell you how he could release it and give the patient extra degrees of movement. I suppose some of it was learned, but can't help but feel that it was mostly God-given. (or innate, if you're that way inclined)
However, he was the rudest man I have ever come across; and yet I would crawl over hot coals to work for him again. Some people couldn't hack it. And, I believe, he could be mean spirited, but at least he was consistent. I've worked for various bosses who had short fuses, and found that difficult. But this fella... always, always rude.
Our conversations would go like this:
Me: "Good morning, sir. How are you this morning?"
Him: "Why don't you fuck off, you brown nosing little shite?"
Me: "Thanks you, sir. I'll see you on rounds, shall I?"
Him:"Why haven't you taken up something you're more suited to, like occupational homeopathy?"
I cut my teeth operating with him behind me shouting in my ear: "Jesus Christ, boy! What are you doing? The patient's bleeding to death, and you're just buggering about! Sort it out!"
On occasion, he would approach me, and, inevitably, shout: "Shroom! I'm feeling very uncomfortable!.
Me (trying not to screw up another shave and graft) "I'm sorry, sir. Why is that?"
Him: "My fucking trousers are falling down!"
Me: "I'm not sure how I can help, sir..."
Him: "You fucking can't! I just wanted to tell someone..."
Happy Days...
However, he was the rudest man I have ever come across; and yet I would crawl over hot coals to work for him again. Some people couldn't hack it. And, I believe, he could be mean spirited, but at least he was consistent. I've worked for various bosses who had short fuses, and found that difficult. But this fella... always, always rude.
Our conversations would go like this:
Me: "Good morning, sir. How are you this morning?"
Him: "Why don't you fuck off, you brown nosing little shite?"
Me: "Thanks you, sir. I'll see you on rounds, shall I?"
Him:"Why haven't you taken up something you're more suited to, like occupational homeopathy?"
I cut my teeth operating with him behind me shouting in my ear: "Jesus Christ, boy! What are you doing? The patient's bleeding to death, and you're just buggering about! Sort it out!"
On occasion, he would approach me, and, inevitably, shout: "Shroom! I'm feeling very uncomfortable!.
Me (trying not to screw up another shave and graft) "I'm sorry, sir. Why is that?"
Him: "My fucking trousers are falling down!"
Me: "I'm not sure how I can help, sir..."
Him: "You fucking can't! I just wanted to tell someone..."
Happy Days...
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